BACKGROUND:

Many with a mental illness have an impoverished everyday life with few meaningful activities and a sedentary lifestyle. The study aim was to evaluate the effectiveness of the 16-week Balancing Everyday Life (BEL) program, compared to care as usual (CAU), for people with mental illness in specialized and community-based psychiatric services. The main outcomes concerned different aspects of subjectively evaluated everyday activities, in terms of the engagement and satisfaction they bring, balance among activities, and activity level. Secondary outcomes pertained to various facets of well-being and functioning. It was hypothesized that those who received the BEL intervention would improve more than the comparison group regarding activity, well-being and functioning outcomes.

METHODS:

BEL is a group and activity-based lifestyle intervention. CAU entailed active support, mainly standard occupational therapy. The BEL group included 133 participants and the CAU group 93. They completed self-report questionnaires targeting activity and well-being on three occasions - at baseline, after completed intervention (at 16 weeks) and at a six-month follow-up. A research assistant rated the participants' level of functioning and symptom severity on the same occasions. Non-parametric statistics were used since these instruments produced ordinal data.

RESULTS:

The BEL group improved more than the CAU group from baseline to 16 weeks on primary outcomes in terms of activity engagement (p < 0.001), activity level (p = 0.036) and activity balance (p < 0.042). The BEL group also improved more on the secondary outcomes of symptom severity (p < 0.018) and level of functioning (p < 0.046) from baseline to 16 weeks, but not on well-being. High intra-class correlations (0.12-0.22) indicated clustering effects for symptom severity and level of functioning. The group differences on activity engagement (p = 0.001) and activity level (p = 0.007) remained at the follow-up. The BEL group also improved their well-being (quality of life) more than the CAU group from baseline to the follow-up (p = 0.049). No differences were found at that time for activity balance, level of functioning and symptom severity.

CONCLUSION:

The BEL program was effective compared to CAU in terms of activity engagement. Their improvements were not, however, greater concerning other subjective perceptions, such as satisfaction with daily activities and self-rated health, and clustering effects lowered the dependability regarding findings of improvements on symptoms and functioning. Although the CAU group had "caught up" at the follow-up, the BEL group had improved more on general quality of life. BEL appeared to be important in shortening the time required for participants to develop their engagement in activity and in attaining improved quality of life in a follow-up perspective.

TRIAL REGISTRATION:

The study was registered with ClinicalTrial.gov. Reg. No. NCT02619318 .

OT emphasis lies within the scope of improving daily life activities, cognitive and physical performance in order to regain the proper social role. This work assesses the impact of a 12 session structured OT intervention program for patients with SUD in IPD. Benefitting from checklists like the Montreal Cognitive Assessment (MoCA), the Barthel Index, the Lawton-Brody IADLs scale, it substantiates attaining enhancements in expressive cognitive functions, ADLs, and IADLs to understand how selected OT intervention modalities can enhance functional capabilities.

AIM:

The goal of occupational therapy (OT) is to facilitate adjustments to lifestyle and to prevent function loss. This study evaluated the effects of an early OT programme in early rheumatoid arthritis (RA).

METHODS:

We conducted a randomised, blind, controlled trial enrolling 60 patients with early RA, divided into 2 groups. At baseline, group 1 received the full information programme and group 2 received no information. In an extension phase, patients in group 2 received the full information programme at 3 months and were assessed at 6 months. The main outcomes were grip strength of hands (as objective assessment) and Health Assessment Questionnaire (HAQ) score (as subjective assessment).

RESULTS:

At 3 months, grip strength of the dominant and non-dominant hands increased more in group 1 than in group 2 (p = 0.021 and 0.047 respectively). HAQ score decreased more in group 1 than in group 2 (p<0.001). In the extension phase, changes in grip strength and HAQ score in group 2 were similar to those seen in group 1 between baseline and 3 months.

CONCLUSIONS:

This study comparing two schedules of OT programme showed that an early extended information programme improved hand function in patients with early RA.

Background: To encourage patient goal setting and active participation in their own rehabilitation, physicians should provide patients with evidence-based prognostic predictions. Objective: This study aimed to analyze whether logarithmic time series changes in the Fugl-Meyer Assessment (FMA) score of the upper extremity (from treatment to one month after treatment) owing to NovEl intervention using repetitive transcranial magnetic stimulation and intensive occupational therapy (NEURO) conformed to logarithmic model formulae (group level), and whether the FMA score could be predicted by applying pre/posttreatment FMA scores following the model equation (individual level). Methods: This retrospective, longitudinal study included 514 poststroke paralysis patients admitted to our hospital between March 2010 and December 2018. FMA scores at 3 time points (before, after, and 4 weeks after treatment) were assessed, and conventional logarithmic regression analyses were performed to determine the time course of motor recovery. Subjects were randomly divided into 2 groups in derivation (n = 257) and validation (n = 257) analysis. Results: The time series change in the FMA score correlated with logarithmic model formulae (r2 =.97). The FMA score was substituted for the logarithmic formulae, and individual FMA scores (4 weeks after NEURO treatment) were predicted. The r2 value between the predicted and measured FMA scores was.65. Conclusions: The logarithmic model based on FMA scores before and after NEURO treatment individually predicted approximately 65% of FMA scores 4 weeks after treatment. NEURO allows the physicians to explain the prognosis to individual patients so that they can participate in their rehabilitation practices and achieve their goals.

This project will enable optimization of specific carried out by occupationist for older adults discharged from hospital for falls:

* on the environmental dimension at the participant\'s home
* on the involvement of the caregiver since they are also involved in the care of the patient
* on the recurrence of falls and rehospitalizations in order to improve the quality of life by reassuring the elderly person when traveling
* on limiting loss of autonomy and staying at home. The occupational therapist will entrust the caregiver with a support role. The participant will feel more involved in the participant\'s care (thus reducing the feeling of helplessness). His actions will allow him to strengthen his sense of competence and will prevent him from physical and psychological exhaustion.

To gather information on occupational therapy practitioners’ use and opinions of apps, an online survey was distributed to occupational therapy practitioners licensed in the state of Ohio. The survey sought information regarding clinical populations and skill areas for which apps are used, potential barriers to use of apps and preferred apps/app features. OTs working in medical and education-based settings and with clients of all ages responded to the survey. Over half (53%) reported not using apps in therapy, with “not having access to the technology at work” being the leading reason endorsed. Of practitioners who did report using apps, the majority used them with ≤25% of their case load and primarily used tablets to do so. Clinicians indicated that they use apps for a wide variety of reasons, including to promote skill building and to support the therapeutic process. Preferred features included the ability to grade difficulty up/down, multiple uses and accurate feedback. Recommendations from peers were the most commonly reported way respondents found new apps. The results suggest that occupational therapy practitioners employ clinical reasoning when implementing apps in therapy. Possible ways to improve access to apps for therapists who would like to implement them are discussed.Implications for RehabilitationMany occupational therapy practitioners are using apps with at least a portion of their caseloads.Therapists select apps based on peer recommendations, most commonly selecting those which promote skill building and support the therapeutic process.More therapists might make use of apps if potential barriers were reduced or eliminated, including availability of technology in the clinical practice setting, therapist training and education, therapist input into app development and an enhanced evidence base.

OBJECTIVES:

The purpose of this work was to assess the effect of botulinum toxin A and occupational therapy compared with occupational therapy alone on body structure, activities participation, and self-perception in a sample of children (aged 3-16 years) with hemiplegic cerebral palsy recruited from a statewide register.

PATIENTS AND METHODS:

Participants of this single-blind, randomized, controlled trial identified from a population-based cerebral palsy register received either an individually prescribed and localized injection of botulinum toxin A with 4 sessions of occupational therapy over 4 weeks (intervention) or occupational therapy alone (control). Outcomes were assessed from 2 domains of the World Health Organization International Classification of Functioning, Disability, and Health: body structure (Modified Ashworth Scale and Tardieu Scale) and activities participation (Assessment of Motor and Process Skills, Goal Attainment Scale, Pediatric Evaluation of Disability Inventory, and Pediatric Quality of Life Inventory). Self-perception was also measured.

RESULTS:

All of the participants (intervention: n = 21; control: n = 22) provided data at baseline and 3 and 6 months. Mean age was 8.6 years; 23 were boys and 20 were girls. At 3 months, children allocated to receive the intervention performed significantly better in terms of body structure and activities participation. They reported improvements in self-perception for the global self-worth domain. At 6 months, the differences between the intervention and control groups persisted for the measures of body structure but not for activities participation or self-perception.

CONCLUSION:

Botulinum toxin A injection combined with a low-intensity occupational therapy program achieves significant improvements in body structure, activity participation, and self-perception.

BACKGROUND:

Current clinical guidelines recommend that a multidisciplinary team inclusive of allied healthcare practitioners deliver assessment and intervention for disorders of consciousness. Allied health professionals include music, occupational, physical, and speech therapists. These allied health clinicians are challenged to select interventions due to a lack of evidence-based recommendations regarding rehabilitation interventions that support recovery of consciousness. This umbrella review synthesizes available systematic reviews (SRs) that describe occupational, speech and language, physical and/or musical therapeutic interventions for people with disorders of consciousness.

OBJECTIVES:

Identify and summarize evidence from systematic reviews (SRs) that examine allied healthcare interventions for patients with disorders of consciousness. Additionally, this umbrella review aims to evaluate the impact of allied health interventions on recovery of consciousness, methodological quality and risk of bias for the included systematic reviews.

METHODS:

An umbrella review was completed. The review was reported according to the Preferred Reporting Items for Overview of Reviews (PRIOR) guidance. Five academic databases (PubMed, CINAHL, PsycInfo, Web of Science, and the Cochrane Library) were searched for SRs and/or meta-analyses of allied health (i.e., music, occupational, physical, and speech therapy) interventions for disorders of consciousness. For included studies, data were extracted and quality of the SRs appraised using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 checklist. Data extracted from each SR identified the authors and years of primary studies, interventions, comparators, and outcomes related to recovery of consciousness (i.e., neurobehavioral/cognitive), functional status, physiological response pain, and adverse events. Rehabilitation interventions were categorized and described.

RESULTS:

Fifteen SRs were included and three of these reviews conducted meta-analyses. Identified rehabilitation interventions included: 1) sensory stimulation, 2) median nerve stimulation, 3) communication/environmental control through assistive technology, 4) mobilization, and 5) music-based therapy. SRs were published between 2002 and 2022 and included 2286 participants. Using the AMSTAR 2, the quality of reviews was critically low (k = 6), low (k = 3), moderate (k = 4), and high (k = 2). SRs within this umbrella review demonstrated significant heterogeneity in research methods and use of outcome measures to evaluate the recovery of consciousness within the primary studies. These factors influenced the ability to conduct meta-analyses.

CONCLUSIONS:

Sensory stimulation, median nerve stimulation, music therapy and mobilization are all interventions that demonstrate some level of benefit, but current SRs fail to prove benefit through high-level quality evidence. There is an indisputable need for continued rehabilitation research to expand options for treatment modalities and to ensure that the interventions being applied to DoC rehabilitation are evidence-based to improve consciousness and recovery.

As part of the assessment of a communication course taught jointly to second year physiotherapy and occupational therapy students, they wrote essays evaluating the impact of therapist communication skills on patient satisfaction, compliance and recovery. Analysis of essay content showed that students from both professions were generally aware of clients' cognitive needs and usually portrayed the therapist and patient as partners in effective treatment. However, there were wide individual differences in the volume of discussion relating to clients' emotional needs and the role of therapist listening and relationship skills in effective communication. As a group, there was a tendency for physiotherapy students to give less weight to responding skills, with the exception of acknowledging the need to work with patients' anxiety. Differences in attitudes between the two professions were also manifest in students' evaluations of the ‘relevance' of the communication course to their professional development. Curriculum pressures and less diverse placement experiences may have a role to play in these differences, and their influences are worthy of further investigation. The somewhat different focus of the two student groups indicates that interprofessional teaching may need to address attitudes and values transmitted in other parts of training. Content analysis of essays, while time-consuming, may assist tutors in planning and delivering interprofessional courses which acknowledge students' needs and perspectives.

INTRODUCTION:

In many countries, the COVID-19 pandemic resulted in sudden changes to the delivery of health professions education in response to local and national lockdowns. Within occupational therapy, university education programs traditionally delivered in face-to-face classroom, and clinical settings, the transition to online learning presented unique issues and challenges for faculty and students. This study compared the experiences and perceptions of learning in two groups of occupational therapy students during the pandemic: one group converted to online learning only and the other had a blended approach that combined face-to-face on-campus learning with some online lecture content delivery.

METHODS:

Two hundred and eight (n = 208) undergraduate occupational therapy students from three Australian universities completed an online self-report demographic questionnaire and two standardised instruments: the Student Engagement in the e-Learning Environment Scale and the Distance Education Learning Environment Scale. An independent-samples t test with bootstrapping was completed to examine differences in students' scores.

RESULTS:

Statistically significant differences were observed between the online and blended learning groups across a range of the SELES and DELES subscales. The strongest findings related to psychological motivation (p = 0.001), personal relevance (p = 0.001), interactions with instructors (p = 0.002), instructor support (p = 0.001), student interaction & collaboration (p = 0.001), and cognitive problem solving (p = 0.001).

CONCLUSION:

Occupational therapy students who transitioned to online-only learning experienced higher levels of motivation, interactions with instructors and peers, and self-directed learning than students who experienced a blended education delivery approach of face-to-face and online learning. The findings extend educators' understanding of the matrix of factors that have impacted students' education during COVID-19 and support the development of contemporary and pedagogically sound online and traditional modes of occupational therapy instruction. The results provide evidence of the importance of well-structured programs that facilitate active and flexible learning, provide meaningful and positive experiences, and promote initiatives safeguarding social and personal well-being. Further research in this area is recommended.